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PubMed1990

HMO enrollment by Medicare beneficiaries in heterogeneous communities.

This study examines the effect of ethnicity, race, and other socioeconomic and utilization variables on belonging to a fee-for-service or capitated plan by Medicare beneficiaries. Native-born beneficiaries cite health status, physical access to health care facilities, and income levels as affecting their choice. Immigrants, on the other hand, mention age, a lifestyle of living alone, and income as influencing their decision. Among foreign-born nationals, race appears to play an important role in choosing health care plans. A key factor affecting enrollment among immigrant populations appears to be the availability of ethnic sensitive providers of health care. While the elderly Hispanic immigrant population utilizes participating providers in prepaid plans catering to a Spanish-speaking population, the lack of similar facilities among predominantly black immigrant neighborhoods inhibits participation in HMOs by elderly immigrants from places such as Haiti and the Caribbean Basin. Policy implications are discussed.

Aged↗
PubMed1977

Histocompatibility determinants in Israeli Jewish patients with multiple sclerosis.

The distribution of 24 HLA antigens of the A and B loci was investigated in 197 Israeli Jewish patients with multiple sclerosis (MS) from various Jewish ethnic origins including central and eastern Europe, countries bordering the Mediterranean, the Middle East and from native-born Israelis. The results were compared with the HLA antigen frequencies in a control sample of 455 unrelated individuals representing the general Jewish population. The frequency of HLA-Bw40 among all MS patients (15%) was significantly greater (P less than 0.001) than among the controls (7%). In contrast to the findings in MS patients from other populations, there was no increased frequency of A3 and B7 and Dw2 was present in only one out of 28 patients. The study showed a similar distribution of HLA-A and -B locus antigens, especially of Bw40, in Jews of diverse ethnic origins represented in the control group.

Epitopes↗
PubMed1985

The prevalence of intestinal parasites in children living in an unincorporated area in rural northern Florida.

A survey was conducted to assess the prevalence of intestinal parasitism in 65 native-born preschool and school-age children living in an unincorporated area of northern Florida. Fifty-seven percent of the children were found to be infected with intestinal parasites. Sixty-eight percent of males surveyed and 47% of females had either single or multiple infections. Prevalence was greatest in the five-10-year-old age group. For the total child population surveyed, parasitic infections in order of most to least prevalent were ascariasis (32%); giardiasis (29%); trichuriasis (14%); and hookworm (2%).

Adolescent↗
PubMed1978

Tuberculosis among immigrants in Britain. Memorandum from the Joint Tuberculosis Committee.

Tuberculosis is much commoner among immigrants to Britain than among the native-born. In 1971, 5% of the population were immigrants yet they accounted for 32% of tuberculosis cases. The notification rate among immigrants is falling in some areas but rising in others, and many immigrants are still arriving in Britain. Most immigrants arrive at London Airport, and as many as possible are x=rayed there with the resources available; Many cases escape detection, however, and it is therefore important that accurate information about all immigrants is sent to the medical officer for environmental health at their destination. New arrivals should then be sought out, tuberculin-tested, and positive reactors x-rayed. All those who are tuberculin-negative should be vaccinated with BCG whatever their age. Positive reactors should undergo annual radiography and be encouraged to report symptoms early. For both new and established immigrants with strongly positive tuberculin reactions chemoprophylaxis is suggested. All children of immigrants should be given BCG at birth and tuberculin-tested when they start school so that omissions can be rectified. Implementation of these recommendations could contribute considerably to the control of tuberculosis in Britain.

Africa↗
PubMed1971

On the risk of multiple sclerosis according to age at immigration to South Africa.

In a national prevalence study of multiple sclerosis (M.S.) in the Republic of South Africa based on census day 1960 there were 118 individuals with M.S. who were born in Northern Europe (United Kingdom and other parts of North and Central Europe) and who had emigrated to the Republic by 1960. Their prevalence rate was 49 per 100,000 immigrants in comparison with a prevalence of 11 per 100,000 among native-born English-speaking white South Africans.To study the possible effect of age at immigration it was necessary to relate the M.S. immigrants to the appropriate denominator-the population at risk according to age at immigration. The population at risk by age at immigration has been estimated by two methods in an indirect fashion with the assistance of the Bureau of Census (1960) and by surveys of the population at risk 1968-9. Both studies suggest that the risk of developing M.S. was reduced to less than a third of the expected risk among those who immigrated under the age of 15 or 16.This study is further evidence that M.S. is an acquired exogenous disease, the precise nature of which is still not certain but, according to present knowledge, has as its leading contender the class of slow, latent, or temperate viruses.

Adolescent↗
PubMed1985

Autochthonous cutaneous-subcutaneous leishmaniasis on Taiwan.

Leishmaniasis was not considered to be endemic on Taiwan, but during and after World War II a number of cases of kala-azar and post-kala-azar dermal leishmaniasis have been seen. The majority of the cases occurred in soldiers (Japanese and Chinese) who acquired infections on the China mainland. This paper presents the first reports of autochthonous cutaneous-subcutaneous leishmaniasis in 2 native-born aborigine Taiwanese.

Adolescent↗
PubMedDate not supplied

Risk of low birthweight and prematurity among foreign-born mothers.

Data collected during postnatal visits were used to study the risk of low birthweight (LBW) and prematurity among foreign-born mothers and mothers born in Canada. 2,913 singleton live births were included in the analysis. Odds ratios (OR) and 95% confidence intervals (CI) for LBW and prematurity were estimated using a logistic regression model. Foreign-born mothers did not have a higher risk of LBW or prematurity as compared to native-born mothers (OR = 1.1, 95% CI = 0.8-1.5; OR = 1.0, 95% CI = 0.7-1.4, respectively). For both LBW and prematurity, women in the intermediate category of length of stay (1-3 years) had a somewhat lower risk and women with the shortest length of stay (less than one year) had a slightly higher risk than women with the longest length of stay (more than 3 years). However, none of these results was statistically significant. Results of this study suggest that foreign-born mothers do not have a higher risk than Canadian-born mothers of bearing a LBW or premature infant. This finding differs from the widespread perception that immigrant mothers are at high risk for adverse birth outcomes.

Asia, Southeastern↗
PubMed1990

Epidemiology of alimentary cancers in New South Wales, 1973-82.

Incidence and mortality data from New South Wales (NSW) for 1973-82 were examined using log-linear regression to determine the temporal trends of cancers of the alimentary tract. There were significant increases in incidence of cancers of the colon (1.7%/year), rectum (2.6%/year), and liver (4.0%/year) and decreases for cancers of the oesophagus (-2.2%/year) and stomach (-1.4%/year). By contrast, the mortality decreased significantly for cancers of the colon (-1.0%/year) and pancreas (-1.4%/year) as well as for cancers of the oesophagus (-3.4%/year) and stomach (-4.1%/year). Cancers of the colon, rectum and oesophagus were generally less frequent, and cancer of the stomach was more frequent, among migrants to NSW than among the native-born Australians in NSW. This pattern was most evident in migrants from Greece, Italy, Yugoslavia and England and was absent in migrants from Scotland and New Zealand. When compared with the state as a whole, rural NSW had significantly lower incidences of cancers of the oesophagus, stomach, colon and rectum.

Age Factors↗
PubMed1989

American fertility in transition: new estimates of birth rates in the United States, 1900-1910.

This article presents new estimates of age-specific overall and marital fertility rates for the entire United States for the period 1900-1910. The estimation techniques are the two-census parity increment method and the own-children method. The data sources are the 1900 census public use sample and tabulations of 1910 census fertility data published with the 1940 census. Estimates are made for the total population, whites, native-born whites, foreign-born whites, and blacks. Low age-specific marital fertility at younger ages is consistent with a view of a distinctive American fertility pattern at this time.

Age Factors↗
PubMed1988

[Various indicators of the lipid composition of erythrocyte membranes in healthy persons and in chronic alcoholics in the northeastern part of the USSR].

Some indices of red blood cell membranes lipid composition were studied in normal subjects and alcohol abusers inhabitants of the North-East of the USSR. Increased lipid peroxidation in newcomers was explained by a greater unsaturation level of membrane fatty acids and exhausted lipid antioxidants. Decreased peroxidation in subjects inhabiting the region for over 15 years, native-borns and chronic alcohol abusers could be accounted for by an increase in membrane cholesterol content. The data suggest that lipid peroxidation is a common mechanism of these events.

Adult↗
PubMedDate not supplied

Human T-cell lymphotropic virus type I and adult T-cell leukemia/lymphoma outside Japan and the Caribbean Basin.

Ninety-six patients with the diagnosis of adult T-cell leukemia/lymphoma (ATLL) were identified in countries outside Japan and the Caribbean Basin. Seventy-four of these patients were initially diagnosed in the United States; 25 of 52 patients whose places of birth were known had been born in the United States. The detection of 14 patients born in the southeastern United States, all black, indicates a group deserving particular attention for studies of human T-cell lymphotropic virus type I (HTLV-I), a suspected etiologic agent in most cases of ATLL. Although geographic clustering of ATLL in areas endemic for HTLV-I, particularly southwest Japan and the Caribbean Basin, is a dramatic feature of this disease, a review of the literature indicates that HTLV-I-associated ATLL probably occurs sporadically in a much wider distribution, the disease being diagnosed in native-born African, Chinese, European, and Latin American patients. A registry for ATLL cases is suggested, to assist in the identification of risk factors for this disease and, at the same time, improve case definitions and early diagnosis.

Adult↗
PubMed1978

Recent net alien immigration to the United States: its impact on population growth and native fertility.

Estimates of the size and structure of recent alien immigration to the United States are made. Substituting these revised estimates in the Series II projections of the U.S. Bureau of the Census implies a future U.S. population smaller than that implied by the Census Bureau's estimates of immigration. The analysis of Coale (1972)--which calculates the decline in native-born fertility required to accommodate immigration and, at the same time, maintain a stationary population--is replicated, using both the Census Bureau's estimates and the revised estimates reported here. The revised estimates indicate a smaller reduction in native fertility and a smaller ultimate size of the stationary population than are implied by the Census Bureau's immigration estimates. The importance of age structure in all of these calculations is demonstrated.

Adolescent↗
PubMed1989

Reproductive health of Asian women: a comparative study with hospital and community perspectives.

A comparative study of Asian and non-Asian women's reproductive health was performed. The hospital case notes of 48 Asian and 51 non-Asian women, matched for age, were examined. Asian women had shorter stature, bigger families, booked later for antenatal care, and were less likely to have a cervical smear taken. Of the above, 30 Asian and 24 non-Asian women were interviewed in their homes. Many Asian women had difficulties with the English language and a low literacy rate which gave rise to communication barriers during health care. Their knowledge of procedures and tests such as amniocentesis, self examination of the breast etc. was comparatively low. Fewer Asians attended parent-craft classes or did post-natal exercises. Many disliked, and some refused, vaginal examination by male doctors. Despite equal access, Asian women were less well informed and made lesser use of services. Lack of knowledge and difficulties of communication, rather than negative attitudes, may explain Asian women's lesser use of services and to some extent the poor outcome of pregnancy observed in many studies.

Adult↗
PubMed1991

Teenage pregnancy in Scotland: trends and risks.

Teenage pregnancy, considered to be associated with social and medical risks, is seen as a growing problem. Population based information from the Registrar General (Scotland) and Notification of Abortion permitted an analysis of the trends in the numbers, rates and outcomes of pregnancies among women aged less than 20 years. In addition, clinical information is available on all deliveries in Scottish hospitals from the standard hospital discharge document permitting analysis of the association of defined complications with age. Contrary to current perceptions, pregnancies and births among teenagers are not more frequent in 1988 when compared to 1975. There has been, however, a large increase in births to single women, a group with particular problems. The obstetric risks when compared to older women, are small and probably socially, not age related. These include a slightly higher rate of pre-term delivery and low birthweight and a later presentation for specialist antenatal care. The proportion of pregnancies affected by neural tube defects which are terminated is lower among women under 20. These medical risks are small, however, compared to the well-documented social and economic problems which will have long term and indirect effects on health.

Abortion, Induced↗